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Morning sickness is the nauseated feeling that many women get during the first trimester of pregnancy. Morning sickness can be, but is not always, accompanied with vomiting. It usually starts out in the morning and wears off as you become active throughout your day, but it can actually occur at any time of the day.
Many health care providers believe morning sickness is a good sign because it means the placenta is developing well.
Incidence; Causes & Development
More than half of all pregnant women experience morning sickness.Most pregnant women have at least some nausea, and about a third have vomiting.
The nausea is often a result of the increased hormone levels that result from pregnancy. The exact cause of morning sickness is not known; it may be caused by hormonal changes or lower blood sugar during early pregnancy. Emotional stress, traveling, or some foods can aggravate the problem.
Signs & Symptoms
Nausea and vomiting can be one of the first signs of pregnancy and usually begins around the 6th week of pregnancy. It can occur at any time of the day, and for most women it seems to stop around the 12th week of pregnancy although it can last until the 14th or 16th week.
Diagnosis & Tests
Diagnostic tests that may be performed include blood tests (including CBC and blood chemistry) and urine analysis for ketones and to determine severity of dehydration.
Treatment & Prevention
Recommendations:- In the Morning
- Allow yourself plenty of time to get out of bed - set your alarm an hour early
- Put something in your stomach as soon as you wake up, such as crackers, dry toast or dry cereal
- Get out of bed slowly
- During the Day
- Eat small meals throughout the day to avoid getting too full or too hungry
- Drink small amounts of fluids during the day to avoid dehydration
- Nap during the day
- Eating and Drinking
- Eat small meals often
- Drink fluids 1/2 hour before or after a meal, but not with meals
- Eat whatever you feel like eating, whenever you feel you can. Trust your cravings!
- Ask someone else to cook for you and open the windows or turn on fans if the odor bothers you
- Sniff lemons or ginger, drink lemonade, or eat watermelon to relieve nausea
- Eat salty potato chips (they have been found to settle stomachs enough to eat a meal)
- Try cold foods, bland foods and anything that sounds good to you
- Eat foods high in protein and complex carbohydrates, such as peanut butter on apple slices or celery; nuts; cheese; crackers; milk; cottage cheese; or yoghurt
- For snacks, try lemons (eat, suck or sniff), anything made with ginger (soda, candy, tea, jam, etc.), peppermint tea, crackers, flavored popsicles, pretzels.
- Avoid foods high in fat and salt, but low in nutrition
- Do not lie down after eating
- Do not skip meals
- Do not cook or eat spicy or greasy food
- Do not take a nap right after a meal. This can cause nausea to be worse.
- Evening and Nighttime
- Go to bed early! You need your rest.
- Have a small snack at bedtime
- Take your prenatal vitamins at night
- If you wake up in the middle of the night, try to eat something
- In General
- Get plenty of rest
- Avoid warm places (feeling hot adds to nausea)
- Exercise
- Keep rooms well-ventilated to reduce odors
- Avoid smoking and second-hand smoke
- Avoid taking medications for morning sickness. If you do, consult a doctor first.
Hyperemesis gravidarum is a condition characterized by severe nausea, vomiting, weight loss, and sometimes electrolyte disturbance. Mild cases are often treated with dietary measures, rest and antacids. Severe cases often require a stay in the hospital so that the mother can receive fluid and nutrition through an intravenous line. DO NOT take any medications to solve this problem without consulting your health care provider first.
Prognosis; Complications; Seek medical attention if
Morning sickness is not harmful to you or your baby, but if you experience excessive vomiting and cannot keep your food down, you may have hyperemesis gravidarum. Hyperemesis gravidarum can be harmful to you and your baby if severe and left untreated, due to the possible lack of nutrients and electrolyte imbalance. The degree of morning sickness during one pregnancy does not predict how you will feel in future pregnancies.
Morning sickness does not hurt the baby in any way unless persistent weight loss occurs, such as with the severe vomiting of hyperemesis gravidarum.
Inform your health care provider if symptoms of Hyperemesis gravidarum appear and discuss possible options for treatment. Specifically:- If you are experiencing excessive nausea and vomiting that prevents you from keeping any food down
- If you vomit more than 3 times per day
- If vomiting is accompanied by pain or fever
- If nausea and vomiting persists well into the second trimester (after 16th week.) This happens to some women and is usually normal, but have it checked out.
- If you vomit blood or material that looks like coffee grounds. (Call IMMEDIATELY)
- You lose more than 2 pounds in weight
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Recommendations and treatments for Morning Sickness: | | | | | Oriental Medicine |  Acupuncture | Acupressure wrist bands or acupuncture may help. You can find these bands in drug, health food, and travel stores. If considering acupuncture, talk to your doctor and seek an acupuncturist trained to work with pregnant women. |
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Vitamins |
 Vitamin B6 (Pyridoxine)| | Increase vitamin B6 in your diet by eating whole grains, nuts, seeds, and legumes. Talk to your doctor about possibly taking vitamin B6 supplements. Taking vitamin B6 (50mg daily) has been shown to help with pregnancy-induced nausea. |
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KEY | | Likely to help | | | Highly recommended |
GLOSSARY
Antacid (Antacids)
Neutralizes acid in the stomach, esophagus, or first part of the duodenum.
Complete Blood Count (CBC)
A set of measurements that are generally determined by specially designed machines that analyze the different components of blood in less than a minute. The values generally included are:- White blood cell count (WBC). The number of white blood cells in a volume of blood. Normal range varies slightly between laboratories but is generally between 4,300 and 10,800 cells per cubic millimeter. This can also be referred to as the leukocyte count and can be expressed in international units as 4.3 - 10.8 x 10^9 cells per liter.
- Automated white cell differential. A machine-generated percentage of the different types of white blood cells, usually split into granulocytes, lymphocytes, monocytes, eosinophils, and basophils.
- Red cell count (RBC). The number of red blood cells in a volume of blood. Normal range varies slightly between laboratories but is generally between 4.2 - 5.9 million cells per cubic millimeter. This can also be referred to as the erythrocyte count and can be expressed in international units as 4.2 - 5.9 x 10^12 cells per liter.
- Hemoglobin (Hb). The amount of hemoglobin in a volume of blood. Normal range for hemoglobin is different between the sexes and is approximately 13 - 18 gm/dl for men and 12 - 16 for women (international units 8.1 - 11.2 millimoles/liter for men, 7.4 - 9.9 for women).
- Hematocrit (Hct). The ratio of the volume of red cells to the volume of whole blood. Normal range for hematocrit is different between the sexes and is approximately 45 - 52% for men and 37 - 48% for women.
- Mean cell volume (MCV). The average volume of a red cell. This is a calculated value derived from the hematocrit and red cell count. Normal range is 86 - 98 femtoliters.
- Mean cell hemoglobin (MCH). The average amount of hemoglobin in the average red cell. This is a calculated value derived from the measurement of hemoglobin and the red cell count. Normal range is 27 - 32 picograms.
- Mean cell hemoglobin concentration (MCHC). The average concentration of hemoglobin in a given volume of red cells. This is a calculated volume derived from the hemoglobin measurement and the hematocrit. Normal range is 32 - 36%.
- Red cell distribution width (RDW). A measurement of the variability of red cell size. Higher numbers indicate greater variation in size. Normal range is 11 - 15.
- Platelet count. The number of platelets in a volume blood. Platelets play a vital role in blood clotting. Normal range varies slightly between laboratories but is in the range of 150,000 - 400,000 per cubic millimeter (150 - 400 x 10^9 per liter).
Complex Carbohydrate (Complex Carbohydrates)
Includes indigestible molecules of fiber (e.g. starch and glycogen). Slowly releases sugar into the bloodstream and also adds the fiber.
Crave (Craving, Cravings)
To have a strong desire for; to feel the need for.
Electrolyte (Electrolytes)
An element or compound that, when melted or dissolved in water or other solvent, breaks up into ions and is able to carry an electric current.
Hormones (Hormone)
Chemical substances secreted by a variety of body organs that are carried by the bloodstream and usually influence cells some distance from the source of production. Hormones signal certain enzymes to perform their functions and, in this way, regulate such body functions as blood sugar levels, insulin levels, the menstrual cycle, and growth. These can be prescription, over-the-counter, synthetic or natural agents. Examples include adrenal hormones such as corticosteroids and aldosterone; glucagon, growth hormone, insulin, testosterone, estrogens, progestins, progesterone, DHEA, melatonin, and thyroid hormones such as thyroxine and calcitonin.
Milligram (mg, Milligrams)
0.001 or a thousandth of a gram.
Nausea
Symptoms resulting from an inclination to vomit.
Protein (Proteins)
Compounds composed of hydrogen, oxygen, and nitrogen present in the body and in foods that form complex combinations of amino acids. Protein is essential for life and is used for growth and repair. Foods that supply the body with protein include animal products, grains, legumes, and vegetables. Proteins from animal sources contain the essential amino acids. Proteins are changed to amino acids in the body.
Stomach
A hollow, muscular, J-shaped pouch located in the upper part of the abdomen to the left of the midline. The upper end (fundus) is large and dome-shaped; the area just below the fundus is called the body of the stomach. The fundus and the body are often referred to as the cardiac portion of the stomach. The lower (pyloric) portion curves downward and to the right and includes the antrum and the pylorus. The function of the stomach is to begin digestion by physically breaking down food received from the esophagus. The tissues of the stomach wall are composed of three types of muscle fibers: circular, longitudinal and oblique. These fibers create structural elasticity and contractibility, both of which are needed for digestion. The stomach mucosa contains cells which secrete hydrochloric acid and this in turn activates the other gastric enzymes pepsin and rennin. To protect itself from being destroyed by its own enzymes, the stomach’s mucous lining must constantly regenerate itself.
Vitamin B6 (B6, B-6)
Influences many body functions including regulating blood glucose levels, manufacturing hemoglobin and aiding the utilization of protein, carbohydrates and fats. It also aids in the function of the nervous system.
Last updated: May 04, 2008
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